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Key points
- The "core 4" brief meditation practices include mindful breathing, scanning, visualization, and gratitude.
- Gratitude work focuses on generating positive appreciation and support and observing its effects.
- Tactics in gratitude meditation include sitting with the idea and identifying a target for gratitude.
Part 4 in a series.
As a quick review, the core foursome includes:
Mindful breathing: Focusing on the sensation of the breath while limiting judgment or added thoughts, this is the primary and most effective technique among the four care tactics for mindfulness. It serves as both an introductory practice for mindfulness and a valuable tool for managing acute stress—a foundation for other momentary mindful exercises.
Scanning: In its various forms, this technique involves shifting awareness sequentially from one phenomenon of personal experience to another, allowing us to focus on specific sensations or aspects of our current moment, such as the breath, body, emotions, and thoughts. It is particularly useful in medical contexts for identifying and managing discomfort, as well as for enhancing self-awareness and a sense of control in various challenging situations.
Visualization: An imaginal tactic often used alongside mindful breathing, this helps us to mentally rehearse and desensitize to feared situations, such as phobias, nightmares, and traumatic experiences. It can involve creating detailed mental pictures of events, including sights, sounds, and sensations. It can generate positive or at least adaptive outcomes, aiming to reduce anticipatory stress and improve confidence in various scenarios.
As with the other minis, these are not necessarily meant to supplant a more formal meditation or other mindfulness practice as a longer-term approach to building the capacity of mindful awareness. But I think of them in a McGyver-esque way—as brief and effective tools for anyone, especially those facing medical challenges—without needing duct tape, pipe cleaners, or a hairpin.
Simplifying them for added accessibility was an aspect of a new academic book I've collaborated on, Mindfulness in Medicine (Springer Nature, out mid-2024), aiming to nudge mindfulness concepts and tactics into the whole of today's leviathan, often mindless healthcare system. Marketing riff over, let's dig into getting grateful.
Positive or aspirational practices are getting more attention in the mindfulness community, as well as in mainstream allopathic medicine, as an aspect of managing medical and emotional suffering. These practices focus less on a momentary awareness of one's state and instead work to generate or access one's positive, aspirational feelings, often prior to or in the midst of discomfort.
Gratitude meditation involves focusing on feelings of appreciation and acknowledging the positive aspects of one's experience, including the opportunity to receive care, the knowledge and expertise of healthcare professionals, and the support of loved ones.
The favored direction is to "open to" images or feelings of gratitude and observe the effect on the heart and mind. The pop-culture metaphor I employ in teaching and writing about this tactic is the old "Iron Chef" trope of a "theme ingredient"—introducing a planned phenomenon into the field of mind instead of quail eggs or raw abalone. (Yes, this trope, as am I, is getting long in the tooth. And hungry. More on this investigational use of meditation practice.)
As usual, we settle into a comfortable but alert posture, set expectations for time, maybe a timer on that set for a couple of minutes, and then begin. Yes, chef, we can employ the basic meditative "mother sauce" here: watch, lose the watching, regain it without too much fuss. We are starting first with a couple of breaths as a warmup, shaking off the rust of any pre-sitting distractions in mind. Then, we pivot into the "theme" of purposely bringing gratitude into our mindscape.
As far as specific tactics in working with gratitude, some options and tactics:
- It can be posed as a question: "What is something I'm grateful for?" "Who am I grateful to?" Let the moment organically generate a response in mind. This is a shortie, so stick to one and focus; breathe into it.
- For others, a more free-association-like moment can suffice. Bring the idea, or even just the word "gratitude," to mind, and put the usual gentle effort into attending to that for a bit.
- Some benefit from a brief "breath in awareness, breath out gratitude to..." a couple of breaths, taking and sending style.
- In any case, the "theme" opened to, we then pull back to witness how the moment is operating in us. What else comes up with the gratitude? Where and how do we feel it? We may sample a quick immersion in that aspiration. And, of course, we may not.
This last part is important. The power of the practice here, even in this brief flavor of it, is in the witness of what happens in the sitting with the state; its impact on the body, heart, head, and "meta."
"Sit with gratitude" is meant to access a possibility, not as some falsely created cover for a crappy moment. The misuse of the practice of gratitude is employing (or recommending) it as a manufactured, phony distraction. It can even be a kind of self-gaslighting. "I've just been robbed, but I have gratitude for learning from that experience" may have a quark of resonance, but come on. ("It's not meant to be ketchup on an overdone steak" could be another culinary metaphor, but I'll try to refrain during this political season.)
As to "gratitude work in the midst of stress," here's a preferable consideration, especially for those struggling with some obvious and acute suffering, albeit with its warning label. Bookending some sitting with direct attention to physical or psychological pain with an "on the other hand, here's what I can also note some gratitude for" breaths can help balance the tension and open to both the painful and positive as co-present aspects of life in the present moment—a more authentic and sincere observation than "completely cover that smoking lump of meat."
That warning label: "Yes, but-ing" gratitude generation can still be a way of walling off from full experiencing and adapting to stressful or painful experiences, albeit more slyly and insidiously, as a kind of false equivalence. It is better, I think, to approach gratitude as a question, an opening to curiosity without a forced expectation of outcome.
Lastly, don't overthink it. The idea of gratitude is just another phenomenon of our experience to behold, attend to, and pay close attention to, and have secondary reactions to witness. A breath, a leg spasm, a bird squawking outside the room; all are "stuff" in mind; thought, a feeling, a cascade of those things in concert are also stuff. We witness, and we also, in this process, cultivate a sense of our capacity that witnesses it.
Sitting with aspirational states is no different in approach, but of course, it can be wonderfully different in content. Sitting with our grief or anger or sadness is by its nature a challenge in identification and adaptation, perhaps less so with a positive state like gratitude.
And, to remind, while longer-form sitting with gratitude or any other aspirational state is its own useful and challenging meditation, this is a brief exercise, a pop of "here's what I can be grateful for." Rather than a forced sense of "play-acting" in a state of mind, this "mighty mini" meditation can foster a sense of resilience and optimism. Bon appétit.
For more of this series, see the core 4 "mighty minis."
References
Sazima MD G. Practical Mindfulness: A Physician's No-Nonsense Guide to Meditation for Beginners. Turner Publishing, 2021.
